The authors report the case of a patient diagnosed with human immunodeficiency virus (HIV) in 1996, who began antiretroviral therapy in that year. In 2003, at the age of 41, he suffered an acute myocardial infarction as the first manifestation of coronary disease obstructing 90% of the anterior descendin artery. Throughout the seven years of therapy, the patient persistently presented an abnormal lipid profile, sometimes severely so. He is now being followed at the infectious diseases clinic. The aim of this article is to draw attention to the cardiovascular consequences of prolonged antiretroviral therapy and the need to be prepared to prevent and treat the cardiac and metabolic complications of patients with a multisystem disease.